Acne, Antibiotics, and the Common Cold

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People who use either oral OR topical antibiotics to treat their acne are more than twice as likely to catch colds, according to a study in the September 2005 Archives of Dermatology. If the results of this study hold up to further investigation, it may change the way acne is treated. Here, the researchers analyzed the experience of over 100,000 people with acne over a fifteen year period. About ¾ of them were treated with antibiotics such as topical erythromycin or clindamycin and/or oral minocycline, doxycycline, or tetracycline.

Those who received any of the antibiotics for at least 6 weeks had more than double the chance of catching colds during the entire following year. The common cold is a virus – not directly affected by antibiotics. But antibiotics, in addition to taking care of harmful bacteria, also attack beneficial bacteria that are part of our body’s defense system, apparently resulting in the increased frequency of viral infections.

It surprises me that topical antibiotics on the skin of the face would have the same effect as oral antibiotics, but previous research has shown that topical antibiotics can change the characteristics of bacteria on the skin, even far from the site of application. They can also change the bacteria in the nose passages, and on the skin of people close to the user. And the odds of being a carrier of resistant Group A Strep are higher in people treated with oral or topical antibiotics.

This study does not suggest that antibiotics be abandoned when treating acne, but that their effects on subsequent infections be included when weighing their benefits and costs. Over 2 million people each year in the United States alone have acne severe enough to deserve treatment. That’s a lot of colds to consider!

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.